The frontiers of new psychedelic therapies: A survey of sociological themes and issues

This paper (2022) identifies and discusses sociological issues related to the medicalisation of psychedelic-assisted therapies. Three key areas discussed include the role of advocacy in the advancement of scientific research and the destigmatisation of psychedelics; issues related to the medicalisation and pharmaceuticalisation; and integration into healthcare systems.

Abstract

“Psychedelic compounds are on the cusp of being approved by medical regulators for treatment-resistant mental health disorders. Following promising clinical trials, and as rates of mental ill-health rise globally, psychedelic medicine presents a new paradigm for treating depression, anxiety, addiction and post-traumatic stress disorder. The novelty of psychedelic therapies, the cultural stigma they elicit, and the challenges of regulation and implementation urgently call for a sociological lens onto this emerging field of psychiatry. This article identifies key sociological issues related to the medicalisation of psychedelic-assisted therapies. It begins with a brief overview of the field’s history and current treatment approaches. We then identify and critically examine three areas of sociological interest: the role of advocacy in the advancement of scientific research and the destigmatisation of psychedelics; issues related to the medicalisation and pharmaceuticalisation; and integration into healthcare systems. The challenges and affordances of psychedelics to existing therapeutic models, regulation and monetisation are highlighted, and the socio-political context of the pharmaceutical industry, research, investment and implementation is examined. Drawing on health science literature in this field, the article offers a sociological lens on clinical psychedelic medicine as an emerging and potentially paradigm-shifting field of psychiatry and psychotherapy.”

Authors: Timothy Andrews & Katie Wright

Notes

Research papers pertaining to the therapeutic potential of psychedelics are emerging on what is now a daily basis. These papers are providing us with the necessary clinical evidence that would see psychedelics transformed from Schedule I substances into viable therapy options, yet more can be done to facilitate this transformation. While evidence from clinical trials and laboratories is undoubtedly necessary, the field of psychedelics could benefit from a more multidisciplinary approach and widening its lens and delving deeper into the qualitative realms of science.

The present study does exactly that. In this paper, the authors identify and discuss some of the key sociological issues related to the medicalization of psychedelics. The sociological lens is rare in this field and offers perspective on the implications of the supposed paradigm shift of psychedelic medicine has on society. After briefly summarizing the history of psychedelics, the authors discuss three key areas of interest: 1) the role of advocacy in the advancement of scientific research and the destigmatisation of psychedelics; 2) issues related to the medicalisation and pharmaceuticalisation; 3) and integration into healthcare systems.

Key points:

1. Given the support from key organizations, institutions and indivieuals, the promotion of medical research in this field can be usefully understood as a form of health advocacy—the application of information and resources to reduce health problems and effect systemic change.
2. A sociological lens of medicalisation helps to illuminate the socio-medical frameworks and discourses that structure the advocacy and research paradigms that will shape the entry of psychedelic therapies into formal healthcare. Psychedelics present an unusual case for the creation of a medical treatment insofar as they have long histories and diverse cultural imaginaries attached to the
3. The anticipated rescheduling of psychedelic compounds following recognition of their medicinal and therapeutic application raises several questions regarding what psychedelic medicine and psychotherapy would look like in practical application. 
4. The legal and cultural settings in the various countries where psychedelic medicines are proposed will shape processes of reclassification, regulation and control of these compounds. Negotiating the stigmas, the War on Drugs, the tensions between medicalisation and decriminalisation, as well as the structures of proposed regulation, will challenge authorities and likely have profound consequneces.
5. There is little doubt that private interests will play a major role in shaping any future roll out of psychedelic-assisted therapies. A major concern for researchers, medical professionals and commentators alike is the potential disjuncture between for-profit business models and public health.

This paper is one of the few to take the view of the field of psychedelics through the lens of sociology. The key points provided here are brief but are eloquently expanded on within the text where the authors provided even more food-for-thought. The world of biomedicine tends to focus on the material and quantifiable but a lot can be learned from the less objective disciplines like sociology. Such perspectives ask the questions that numbers cannot answer and in doing so provoke thoughts, spur conversation and maybe even inspire a lab-based experiment or two.

Summary of The frontiers of new psychedelic therapies: A survey of sociological themes and issues